System and method for percutaneous coronary artery bypass

Abstract

A percutaneous system for bypassing a restriction in a native vessel of a mammal having an aorta includes providing a graft having a body portion with a first end, a second end and a lumen therebetween. An aperture is formed in the aorta. The graft is inserted into the aorta and the first end of the graft is connected to the aorta about the aperture in the aorta. An aperture is then formed in the native vessel distal of the restriction. The second end of the graft is connected to the native vessel about the aperture therein such that the lumen in the graft communicates with the aorta and the native vessel.

What is claimed is: 
     
       1. A method of bypassing a restriction in an artery of a mammal having an aorta, the method comprising:
 providing a graft having a body portion with a first end, a second end, and a lumen extending therebetween, wherein the graft includes a removable tip portion extending from a distal end of a catheter; 
 forming an aperture in the aorta; 
 inserting the graft into the aorta; 
 connecting the first end of the graft to the aorta about the aperture in the aorta; 
 advancing the body portion of the graft through the aperture in the aorta; 
 forming an aperture in the artery distal of the restriction by advancing a wire across the restriction and forming the aperture in the artery with the wire; 
 connecting the second end of the graft to the artery about the aperture therein such that the lumen in the graft communicates with the aorta and the artery; and 
 detaching the graft from the distal end of the catheter. 
 
     
     
       2. The method of  claim 1 , further comprising:
 advancing a snare through the aperture in the aorta; 
 capturing a distal end of the wire with the snare; 
 moving the distal end of the wire into the aorta with the snare; and 
 advancing the graft over the wire between the aorta and the artery. 
 
     
     
       3. A method of securing a graft to a vessel, the method comprising:
 providing a graft having a body portion with a first end, a second end and a lumen extending therebetween, wherein the graft includes a removable tip portion of a catheter; 
 forming an aperture in the vessel; 
 advancing a snare through the aperture in the vessel; 
 advancing a wire across the restriction in the artery and forming an aperture distal of the restriction with the wire; 
 capturing a distal end of the wire with the snare; 
 moving the distal end of the wire into the vessel with the snare; 
 advancing the graft over the wire between the vessel and the artery; 
 connecting the first end of the graft to the vessel about the aperture in the vessel; 
 connecting the second end of the graft to the artery about the aperture in the artery such that the lumen in the graft communicates with the vessel and the artery; and 
 disconnecting the graft from the catheter. 
 
     
     
       4. A method of percutaneously attaching a graft to a vessel, the method comprising:
 providing a graft; 
 forming a substantially round aperture in the vessel; 
 providing a coupler comprising a first portion comprising an insertable portion securable to an end of the graft and a second portion comprising an annular shoulder securable to the vessel; and 
 connecting the graft to the vessel by positioning the coupler proximate the aperture in the vessel; 
 wherein the first portion of the coupler is secured to an inner surface of the graft and the second portion of the coupler is secured to an inner wall of the vessel. 
 
     
     
       5. The method of  claim 4 , wherein the second portion of the coupler has a diameter that is greater than a diameter of the aperture formed in the vessel.